倍频视野计对视野前期开角型青光眼视野进展的风险预测——8年随访研究

Potential of Frequency-Doubling Technology Perimetry for Predicting the Risk of Future Visual Field Loss on Standard Automated Perimetry for Preperimetric Open-Angle Glaucoma The Outcome of 8-year-follow-up

目的探索倍频视野检查法(frequency-doubling technology perimetry,FDP)对视野前期开角型青光眼(open-angle glaucoma,OAG)在将来标准自动视野检查法(standard automated perimetry,SAP)上出现视野异常的风险预测能力.方法前瞻性队列研究.对单眼SAP视野异常(Octopus,G2程序)OAG患者视野正常眼进行基线FDP-N30程序检测,将FDP的19个刺激区匹配至SAP视野的53个测试点,之后连续8年SAP视野随访,最终计算FDP刺激区的异常转化为将来SAP相应区域视野异常的相对危险度(relative risk,RR).结果48例患者完成了8年随访.基线时,912个FDP刺激区中有21%(196/912)检测出异常,其中26%(51/196)的异常刺激区在4~90个月转化为SAP相应区域的视野异常.FDP刺激区的异常转化为将来SAP相应区域异常的RR为5.50(95%置信区间3.53~8.58,p<0.001).结论在视野前期OAG中,FDP可以在一定程度上对将来SAP视野的异常进行准确的风险预测.

Objective To explore the potential of frequency-doubling technology perimetry(FDP)for predicting the risk of future visual field loss on standard automated perimetry(SAP)for preperimetric openangle glaucoma(OAG).Methods A prospective cohort study.OAG patients with unilateral field loss detected by SAP(Octopus,G2 program)were examined with the FDP N-30 threshold program(Humphrey Instruments)at baseline.53 of the SAP test points were matched to the 19 of FDP sectors as SAP-on-FDP sectors.Visual field examinations were followed by a series of SAP examinations for the perimetrically normal eyes administered over 8 years.The relative risk(RR)of subsequent SAP abnormality corresponding to FDP abnormal sectors in perimetrically normal eyes of participants at baseline was calculated finally.Results Forty-eight perimetrically normal eyes of 48 participants had complete data and a qualifying follow-up.At baseline,there were 912 FDP sectors in the 48 eyes with normal SAP results,from which 21%(196/912)were abnormal.During the 8-year-follow-up,26%(51/196)for FDP abnormal sectors developed an SAP abnormality in the SAP-on-FDP sector in 4 to 90 months after baseline,and the RR of subsequent SAP abnormality corresponding to abnormal FDP sectors was 5.50(95%confidence interval,3.53~8.58;P<0.001).Conclusions In preperimetric OAG,FDP could exactly predict the risk of future visual field loss on SAP to some extent.